HTML Preview Service Training Certificate page number 1.
Training period
CALIFORNIA DEPARTMENT OF EDUCATION
Form T-01 (Rev. 1-02)
Training Certificate
Check (✓) Driver Delegated trainer Instructor
Applicant’s birth date
Check (✓) Original Renewal
Certificate issuance date
Check (✓) Bus type I II
Check (✓) School bus SPAB Transit bus Farm labor Youth bus Other
Date renewal training started
Applicant’s name (Last) (First) (Initial) Driver license number
Employer County
Hours of training Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Total
Classroom
1
In-service
Behind the wheel
ID# ID# ID# Driver’s
A*
B** C*** signature/date
Classroom
2
In-service
Behind the wheel
ID# ID# ID# Driver’s
A*
B** C*** signature/date
Classroom
3
In-service
Behind the wheel
ID# ID# ID# Driver’s
A*
B** C*** signature/date
Classroom
4
In-service
Behind the wheel
ID# ID# ID# Driver’s
A*
B** C*** signature/date
Classroom
5
In-service
Behind the wheel
ID# ID# ID# Driver’s
A*
B** C*** signature/date
*A—State certified instructor’s signature—Classroom training
Grand
** B—State certified instructor’s signature—Behind-the-wheel training
total
***C—State certified instructor’s signature—In-service training
Additional training hours: Classroom
Behind the wheel
FOR STATE USE ONLY
(MUST BE COMPLETED IN THE PRESENCE OF THE EXAMINING STATE AGENCY)
Written test: Failed Failed Failed Passed First-aid test: Failed Failed Failed Passed Waived
Driving test: Failed Failed Failed Passed Certificate issuance date
Training verification
(Driver’s signature)
Exam verification
(Examiner’s signature) (Area)